Using Drugs or Non-Drugs Alternatives to Alter Mental States in the Online, Virtual Era.

Background: In the 1970s a body of literature was generated advocating the alternatives approach for drug misuse prevention and rehabilitation which encouraged healthy nonchemical behaviors leading to reinforcing moods. Although this behaviorally oriented approach was overshadowed with the popularity of cognitive therapy in the 1980s, many of the recommended alternative behaviors remain embedded in cognitive approaches for drug misuse prevention and rehabilitation. One objective of the present study was to replicate, in part, two studies conducted in the 1970s which examined usage patterns of non-drug alternatives. A second objective was to explore of the use of newer technologies like the internet and the smartphone to alter emotional states. A third objective was to examine perceived stress and discrimination experiences on preferences for drug and non-drug alternatives. Methods: Three questionnaires were administered: use of drugs and non-drug alternatives in response to everyday emotions; the Everyday Discrimination Scale; and the Perceived Stress Scale. A total of 483 adults participated; their mean age was 39 years. Results: The results revealed that non-drug alternatives were preferred to drugs in treating experiences of anxiety, depression, and hostility, and to induce pleasure. Drugs were used most often to deal with pain. Experiences of discrimination increased perceptions of stress, and stress, in turn, affected the use of drugs to cope with a range of emotions. Social media and virtual activities were not preferred methods for altering negative moods. Conclusions: Social media may actually be a contributor or cause of distress, rather than a means for reducing it.

A Multi-Factorial Observational Study on Sequential Fecal Microbiota Transplant in Patients with Medically Refractory Clostridioides difficile Infection.

Fecal microbiota transplantation (FMT) is highly effective in recurrent Clostridioides difficile infection (CDI); increasing evidence supports FMT in severe or fulminant Clostridioides difficile infection (SFCDI). However, the multifactorial mechanisms that underpin the efficacy of FMT are not fully understood. Systems biology approaches using high-throughput technologies may help with mechanistic dissection of host-microbial interactions. Here, we have undertaken a deep phenomics study on four adults receiving sequential FMT for SFCDI, in which we performed a longitudinal, integrative analysis of multiple host factors and intestinal microbiome changes. Stool samples were profiled for changes in gut microbiota and metabolites and blood samples for alterations in targeted epigenomic, metabonomic, glycomic, immune proteomic, immunophenotyping, immune functional assays, and T-cell receptor (TCR) repertoires, respectively. We characterised temporal trajectories in gut microbial and host immunometabolic data sets in three responders and one non-responder to sequential FMT. A total of 562 features were used for analysis, of which 78 features were identified, which differed between the responders and the non-responder. The observed dynamic phenotypic changes may potentially suggest immunosenescent signals in the non-responder and may help to underpin the mechanisms accompanying successful FMT, although our study is limited by a small sample size and significant heterogeneity in patient baseline characteristics. Our multi-omics integrative longitudinal analytical approach extends the knowledge regarding mechanisms of efficacy of FMT and highlights preliminary novel signatures, which should be validated in larger studies.

The Need for Trauma Therapy for Victims of Man-Made Trauma Compared to Those of Natural Disaster, a Survey of Health Professionals.

INTRODUCTION: Trauma Aid UK (previously HAP UK & Ireland) conducted three EMDR trainings in Turkey: the first was in Istanbul on 28th November 2013. Since then, 3 groups of mental health trainees attending part 1 of 3 parts EMDR training. In total, 86 clinicians were trained. Also, in June 2016, the first part of a three-part EMDR training in Nepal was completed following the Nepal Earthquake in 2015. The purpose of this study is to assess, analyse and understand the needs of Syrian refugees, who have being experiencing man made trauma since 2011, with Nepalese people who were exposed to the earthquake on 25/4/2015, in their needs for trauma services, training and provision as assessed by mental health professionals working with both groups of people. SUBJECTS AND METHODS: A survey was conducted at the beginning of each of the above-mentioned training courses. Participants were asked to consent to participate in the study and, if they did, they were given the 'The Need for Trauma-based Services' quantitative and qualitative questionnaire, or its Arabic translation. 63 Syrian participants of the Istanbul and Gaziantep EMDR training were compared with 37 Nepalese participants who also completed the survey. RESULTS: The results analysis of these surveys showed significantly higher PTSD prevalence in the man-made trauma of the Syrian conflict compared with the prevalence following the natural Earthquake in Nepal. 52% of the Syrian mental health professionals surveyed suggested that PTSD is the major mental health problem in their country, compared to only 6% of the Nepalese mental health professionals. Both the Syrian (33%) and Nepalese (27%) health professionals surveyed felt that they were only able to meet around a third of their clients' needs. They felt that training in EMDR in their mother-tongue would help increase their meeting of these needs. Other suggestions of service provisions and innovations were made in order to meet more of the needs of their trauma survivors. CONCLUSIONS: This study highlighted a high need for trauma mental health services of the Syrian refugees as reported by mental health professionals working in the neighbouring countries. The important difference of these needs from those of the Nepalese people confirms that man-made trauma can cause much greater mental health disturbance and a higher level of needs. Recommendations for training and service development for Syrian refugees were made.

The potentially conflicted evaluations of others based on their intelligence.

Individual differences in intelligence are apparent and likely to come with important interpersonal consequences. We examined (N = 476) how (manipulated) individual differences in intelligence affect likability ratings of men and women. We found that (1) ratings were generally more favorable than unfavorable, (2) the difference between favorable and unfavorable ratings of the female target differed more than those same evaluations of the male target, (3) the favorable evaluation tendency was present across relative intelligence but weakest when the target was smarter than the participant, (4) the smarter target was rated more unfavorably, and (5) the equally smart target was rated more favorably than the less intelligent target. Results suggest that people are somewhat conflicted in their evaluations of those smarter than they are whereas similarly and less intelligent people presented less of an apparent conflict in evaluations.

Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial.

TRIAL REGISTRATION: The authors confirm that all ongoing and related trials for this intervention are registered. The studies reported in this manuscript are registered as clinical trials at ISRCTN: Pilot ID- ISRCTN15325073 RCT ID- ISRCTN59395217.

External quality assessment demonstrates that PD-L1 22C3 and SP263 assays are systematically different.

PD-L1 inhibitors are part of first line treatment options for patients with advanced non-small cell lung cancer. PD-L1 immunohistochemistry (IHC) assays act as either a companion or a complementary diagnostic. The purpose of this study is to describe the experience of external quality assurance (EQA) provider UK NEQAS ICC and ISH with the comparison of different PD-L1 assays used in daily practice. Three EQA rounds (pilot, run A and run B) were carried out using formalin fixed paraffin embedded samples with sample sets covering a range of epitope concentrations, including 'critical samples' near to clinical threshold cut-offs. An expert panel (n = 4) evaluated all returned slides simultaneously and independently on a multi-header microscope together with the participants own in-house control material. The tonsil sample was evaluated as 'acceptable' or 'unacceptable', and for the other samples the percentage of PD-L1 stained tumour cells were estimated in predetermined categories (<1%, 1 to <5%, 5 to <10%, 10 to <25%, 25 to <50%, 50 to <80%, 80 to 100%). In the pilot and the two subsequent runs the number of participating laboratories was 43, 69 and 76, respectively. The pass rate for the pilot run was 67%; this increased to 81% at run A and 82% at run B. For two 'critical samples', in runs A and B, 22C3 IHC had significantly higher PD-L1 expression than SP263 IHC (p < 0.001), whilst the PD-L1 scores for the other six samples were similar for all assays. In run A the laboratory developed tests (LDTs) using 22C3 scored lower than the commercial 22C3 tests (p = 0.01). After the initial testing, improvement in performance of PD-L1 IHC is shown for approved and LDT PD-L1 assays. Equivalency of approved PD-L1 22C3 and SP263 assays cannot be assumed as the scores cross the clinically relevant thresholds of 1% and 50% PD-L1 expression.

Adolescent's Perceptions of Sexual Relationships Between Students and Teachers.

Very little is known about how people perceive and respond to sexual relationships between students and teachers, and even less is known about how adolescents view these relationships. In this study, a large sample of high school students (N = 1203; Mean age: 16.83) responded to four scenarios describing a sexual relationship between a student and teacher. We manipulated student and teacher age, and the power differential between the student and teacher and we measured perceptions of wrongness and likelihood of reporting the situation. The data indicated that in situations of older students (18 vs. 14 or 16) and younger teachers (21 vs 30 or 40), they are less likely to be perceived as wrong and less likely to be reported. Likewise, situations were judged as more wrong when the power differential between students and teachers was greater. Further, there were strong gender differences, such that females (vs. males) consistently viewed the situations as more wrong and were more likely to report. Implications for future research and policy are discussed.

History of military psychology.

Military psychology is a specialist discipline within applied psychology. It entails the application of psychological science to military operations, systems and personnel. The specialty was formally founded during World War I in the UK and the USA, and it was integral to many early concepts and interventions for psychological and neuropsychological trauma. It also established a fundamental basis for the psychological assessment and selection of military personnel. During and after World War II, military psychology continued to make significant contributions to aviation psychology, cognitive testing, rehabilitation psychology and many models of psychotherapy. Military psychology now consists of several subspecialties, including clinical, research and occupational psychology, with the latter often referred to in the USA as industrial/organisational psychology. This article will provide an overview of the origins, history and current composition of military psychology in the UK, with select international illustrations also being offered.

The Syrian Refugees' Need for Trauma-Based Services, a Survey of Mental Health Professionals.

BACKGROUND: Trauma Aid UK (previously HAP UK &Ireland) conducted three EMDR trainings in Turkey: the first was in Istanbul on 28thNovember 2013. AIM: The purpose of this study is to assess the needs of the Syrian Refugees for trauma services training and provision as assesses by mental health professionals who work with them. SUBJECTS AND METHODS: Amongst the 62 participants of two Istanbul EMDR trainings organised by HAP, 53% were Syrian. We felt it is a unique opportunity to assess the needs of Syrian refugees they are working with. We asked all the participants who are all mental health professionals to complete an Arabic translation of 'The Need for Trauma-based Services Questionnaire' in these trainings. The rest of the participants on the course were from Iraq (18%), Jordan (16%), Egypt (7%) and others from Palestine, Sudan & Libya (6%). All participants completed questionnaires. RESULTS: The results of comparing the needs reported by Syrian mental health professionals showed higher prevalence of PTSD seen by the Syrian mental health professionals (72% compared with 56% in the clients seen by the rest of participants). Also, the Syrian mental health professionals could only meet 34% (SD=17.1) of the needs of their client who suffer from PTSD. The unmet need for trauma therapy was reported as 100% by these professionals. CONCLUSIONS: This study highlighted the high need for trauma mental health services of the Syrian refugees as reported by mental health professionals working in the neighbouring countries. The needs of the Syrian refugees, arriving to the UK because of the very difficult situations, these refugees are coming from, may be met with EMDR therapy. EMDR can be used to help these refugees to be a productive part of the British society.

Part II: Muslims perceptions of British cobat troops.

BACKGROUND: On the 22nd May 2017, suicide bomber Salman Abedi detonated an improvised explosive device (IED) in the Manchester Arena killing 22 people and injuring 116 others. Following the 'massacre in Manchester', the leader of the Labour Party, Jeremy Corbyn, linked UK foreign policy with terrorism on British soil. Controversial and contentious though Corbyn's claims may be, the terrorists themselves have also reported that what motivates them to carry out their abominable atrocities are British military operations in Muslim majority countries. Indeed, on the 22nd May 2013, British serviceman, Lee Rigby, was brutally attacked and killed by Michael Adebolajo and Michael Adebowale near the Royal Artillery Barracks in Woolwich, southeast London. The perpetrators of this heinous act told passers-by at the scene that they wanted to avenge the killing of Muslims by the British Armed Forces. METHODS: We conducted a cross-sectional, mixed-methods study on Muslim perceptions of British combat troops and UK foreign policy. Participants were selected by purposive sampling. We crafted a survey that explored Muslim perceptions of the British military and the government's foreign policy. Response items were on a Likert-scale and there was white space for free text comments which were subjected to thematic analyses. RESULTS: 75/75 (100%) of the participants recruited responded. (75/75 (100%) Muslim participants, 43/75 (57.3%) female participants, 32/75 (42.7%) male participants, mean age 20.5 years, (Std. Dev. ±2.5)). 66/75 (88%) of respondents either agreed or strongly agreed that British military operations in Muslim majority countries have negatively influenced perceptions towards combat troops. 42/75 (56%) of respondents either agreed or strongly agreed that contact with a combat troops or veterans would positively influence their perceptions towards them. Themes of free text comments included the role that the media plays in demonising Muslims, the transcendental bond that Muslims around the world have for each other and 'the brainwashing' of British combat troops by the Government. DISCUSSION: The fact that many of the participants in our sample agreed or strongly agreed that social contact with service personnel or veterans would positively influence perceptions towards them is encouraging. The results of our survey lend support for future intervention studies investigating whether contact between Muslims residing in the UK and British combat troops would promote unity and community cohesion.

A King's College London Undergraduate Psychiatry Society event to challenge the stigma attached to psychological problems in healthcare professionals and students.

BACKGROUND: There are higher levels of psychological distress in healthcare professionals and students compared to the general population. Yet, despite the availability of effective treatment, many in this group continue to suffer in silence. Fear of exposure to stigmatization has been identified to be a major barrier to accessing and using mental health services. King's College London Undergraduate Psychiatry Society (KCL PsychSoc) organized an event entitled, 'What does bipolar disorder even mean? Psychological distress: How can we challenge the stigma?'. Healthcare professionals who themselves recovered from psychological problems and a mental health advocate with first-hand experience of psychological distress were invited to deliver talks followed by an interactive question and answer session. DESIGN: We conducted a single-arm pre-post comparison study. People who attended the KCL Psych Soc event were recruited to participate. Validated stigma scales on knowledge (Mental Health Knowledge Schedule (MAKS), attitudes (Community Attitudes towards the Mentally Ill) and behavior (Reported and Intended Behavior Scale (RIBS)) were administered on participants before and immediately after exposure to the event. RESULTS: 44/44 of the participants recruited completed the study (100% response rate). There were statistically significant changes in the respondents' scores for all 3 stigma scales (p value MAKS<0.0001, p value CAMI<0.0001, p value RIBS=0.0011). DISCUSSION: As far as the authors are aware, this is the first study to date of an anti-stigma intervention comprised of healthcare professionals with first-hand experience of psychological distress. The KCL PsychSoc event was associated with statistically significant changes in the respondents' scores in all three of the stigma scales. More robust research in this area is needed before scaling up similar anti-stigma initiatives.

In a moral dilemma, choose the one you love: Impartial actors are seen as less moral than partial ones.

Although impartiality and concern for the greater good are lauded by utilitarian philosophies, it was predicted that when values conflict, those who acted impartially rather than partially would be viewed as less moral. Across four studies, using life-or-death scenarios and more mundane ones, support for the idea that relationship obligations are important in moral attribution was found. In Studies 1-3, participants rated an impartial actor as less morally good and his or her action as less moral compared to a partial actor. Experimental and correlational evidence showed the effect was driven by inferences about an actor's capacity for empathy and compassion. In Study 4, the relationship obligation hypothesis was refined. The data suggested that violations of relationship obligations are perceived as moral as long as strong alternative justifications sanction them. Discussion centres on the importance of relationships in understanding moral attributions.

Physician heal thyself (Luke 4:23).

The performance culture of the health service means that the psychological well-being of staff is becoming paramount in maintaining the workforce and in sustaining psychological health and morale. A Charter for Psychological Staff Wellbeing and Resilience is introduced that puts the onus on us and on employers to make the necessary adjustments to their workplace cultures and encourage professionals - us - to break through the barrier of stigma.

Introducing the Date and Acquaintance Rape Avoidance Scale.

We present the Date and Acquaintance Rape Avoidance Scale (DARAS). The DARAS is a measure of a woman's behaviors used to avoid date and acquaintance rape. Three factor structures were possible. The DARAS may have measured several factors related to alcohol and drug use, self-defense, and date behaviors; 2 factors related to behaviors to avoid acquaintance versus date rape; or a single factor that represented general vigilance. The data revealed a highly reliable, 63 item single factor that was correlated with stranger rape avoidance, rejection of rape myths, hostile sexist beliefs about men, and benevolent sexist beliefs about women. The creation of the DARAS adds to the growing body of research on rape avoidance. The DARAS is key to understanding the behaviors women employ to avoid date rape. Rather than placing the responsibility for rape on the victim, the DARAS was developed as a theoretical and applied tool that can be used to improve theory and construct rape education and prevention programs.

Relative sensitivity of an amphipod Hyalella azteca, a midge Chironomus dilutus, and a unionid mussel Lampsilis siliquoidea to a toxic sediment.

The objective of the present study was to evaluate the relative sensitivity of test organisms in exposures to dilutions of a highly toxic sediment contaminated with metals and organic compounds. One dilution series was prepared using control sand (low total organic carbon [TOC; <0.1%, low binding capacity for contaminants]) and a second dilution series was prepared using control sediment from West Bearskin Lake, Minnesota, USA (high TOC [∼10% TOC, higher binding capacity for contaminants]). Test organisms included an amphipod (Hyalella azteca; 10-d and 28-d exposures), a midge (Chironomus dilutus; 20-d and 48-d exposures started with <1-h-old larvae, and 13-d and 48-d exposures started with 7-d-old larvae), and a unionid mussel (Lampsilis siliquoidea; 28-d exposures). Relative species sensitivity depended on the toxicity endpoint and the diluent. All 3 species were more sensitive in sand dilutions than in West Bearskin Lake sediment dilutions. The <1-h-old C. dilutus were more sensitive than 7-d-old C. dilutus, but replicate variability was high in exposures started with the younger midge larvae. Larval biomass and adult emergence endpoints of C. dilutus exhibited a similar sensitivity. Survival, weight, and biomass of H. azteca were more sensitive endpoints in 28-d exposures than in 10-d exposures. Weight and biomass of L. siliquoidea were sensitive endpoints in both sand and West Bearskin Lake sediment dilutions. Metals, ammonia, oil, and other organic contaminants may have contributed to the observed toxicity.

Mind attributions about moral actors: intentionality is greater given coherent cues.

Attributions about intentionality and the capacity for agency were explored from coherence perspectives. Coherence perspectives suggest that social perceivers use information about an actor's motives, traits, and the outcomes of action to create meaningful explanations of action. According to the typecasting theory, intentionality and agency attributions should be related and predicted by one's role in a moral dyad. Across four studies, with different operational definitions of moral dyads and agency, we found evidence in favour of coherence perspectives. Social perceivers relied on mental states, character, and behavioural cues to make intentionality judgments. Further, intentionality attributions about behaviours were unrelated to inferences about agency. The discussion centres on the importance of coherent explanation in moral judgment.

Nothing new under the sun: post-traumatic stress disorders in the ancient world.

Herodotus' account of the Athenian spear carrier Epizelus' psychogenic mutism following the Marathon Wars is usually cited as the first documented account of post-traumatic stress disorders in historical literature. This paper describes much earlier accounts of post combat disorders that were recorded as occurring in Mesopotamia (present day Iraq) during the Assyrian dynasty (1300-609 BC). The descriptions in this paper include many symptoms of what we would now identify in current diagnostic classification systems as post-traumatic stress disorders; including flashbacks, sleep disturbance and low mood. The Mesopotamians explain the disorder in terms of spirit affliction; the spirit of those enemies whom the patient had killed during battle causing the symptoms.

Intentional inferences are not more likely than unintentional ones: some evidence against the intentionality bias hypothesis.

We conducted a study to test the hypothesis that inferences about intentionality are biased toward an intentional interpretation. Contrary to previous research, participants were no more likely to judge ambiguous actions as intentional in a speeded compared to an unspeeded condition. Further, participants were faster to respond and more consistent in responding to unintentional rather than intentional actions.

Military mental health professionals on operational deployment: an exploratory study.

This exploratory study aimed to develop greater insight into the occupational and personal nature of the practice of mental healthcare on operational deployments. Twenty-eight British military mental health professionals were identified as having recently returned from deployment, with 35% agreeing to participate in semi-structured qualitative interviews. Results suggest that whilst this population have a range of stressors, their main concern is to work towards the success of the overall mission objectives, mainly through achieving their clinical goals. Such work is impacted by challenges such as ethical difficulties, professional obstacles, bonding with colleagues and personal issues. They do however rely upon a range of intra and inter-personal strategies to overcome these hurdles successfully. A number of suggestions for improved mental healthcare on deployment are also identified. A review of the implications of the findings is offered and recommendations for improved training and support for mental healthcare professionals are explored. Finally, potential avenues for future research are considered.